Team based care
Team based care engages a greater number of staff in patient care and affords physicians, as the team lead, additional time with patients and their families. Team members should be aware of the health history, status, and unique needs of the patient and family, and are assigned different responsibilities, which together are designed to result in continuous, comprehensive, coordinated care during and between visits. As a result, all members of the team feel engaged in their key role of caring for the patient.
A successful collaborative team environment includes the following:
A culture of trust
Clearly defined roles and responsibilities
Respectful and empathetic open communication
Appreciation of diversity
Equal participation among all team members
Consensus decision making
Solution focused problem solving
Creating Efficiency – Team Huddles
Key Elements of Highly Effective Teams, Council on Medical Students Education Pediatrics 2019
Team documentation or “scribing” is a process where team members assist with documenting visit notes, entering orders and referrals, and preparing prescriptions, during a patient visit. (AMA Steps Forward Team Documentation) Medical scribes have been shown to enhance clinical documentation, improve revenue collection, increase physician satisfaction, and reduce burnout. (JAMA 2015; J Am Board Fam Med 2015)
Team Documentation: Improve Efficiency, Workflow, and Patient Care, AMA Steps Forward (CME bearing module)
Assess the physical practice environment
The physical practice environment can also influence physician dissatisfaction. Challenging work environments such as a lack of meeting space, equipment, room availability, etc. can contribute to frustration and ultimately burnout. Assessing the barriers within the physical practice environment may offer opportunities to build a success in creating wellness strategies or organizational changes. Some common changes to the physical environment might include:
Select furniture that enables eye to eye contact with families.
Organize patient rooms that promote communication
Offer a well-designed family or waiting area
Create public spaces that encourage team interaction and communication such as open workstations
Offer sources of natural light and/or images of nature
Space for scribes or other team members to help with EMR input
A respite or wellness room for staff to rest or recover after stressful encounters.
Access to healthy foods and drinks in meeting or lounge spaces
Lengthen visit time if possible
The number of recommendations and tasks pediatricians are expected to complete during a well-child visit continues to grow. Lengthening the time a pediatrician can spend with each family is a possible strategy for reducing the administrative burden. This extra time can be offered as family discussion or supplemental administrative time to complete prescriptions, documentation, or anticipatory guidance.
Patients Over Paperwork, Centers for Medicare and Medicaid Service